Provider Demographics
NPI:1902310147
Name:ISOE, CAROLINE MORAA
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:MORAA
Last Name:ISOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 HYDENWOOD CRES
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-1818
Mailing Address - Country:US
Mailing Address - Phone:757-753-7383
Mailing Address - Fax:
Practice Address - Street 1:1700 HYDENWOOD CRES
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-1818
Practice Address - Country:US
Practice Address - Phone:757-753-7383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily